What future for care?

Peter Beresford
18th Sep 2008

Can 'personalisation' of care take policy and practice into the twenty-first century?

As the numbers of people needing care are rising, major changes are planned for social care policy and practice. 'Personalisation' aims to match support to the rights and needs of the individual rather than slotting them into existing services, and emphasises 'choice and control' for the service user.

Peter Beresford, Brunel University and Shaping Our Lives, makes the following points:

  • there have been increasing pressures for care to be reduced to a set of standardised procedures and services;
  • the 'apparent ordinariness' of care is deceptive and can often hide sophisticated, highly skilled and much valued approaches to personal and social support which address difference and are committed to social justice;
  • care can serve both to reinforce and challenge inequalities and discrimination.
Summary

Summary

Care is a contentious policy concept. Numbers of people needing care are rising. Radical change is planned for care policy to increase choice and control through ‘personalisation’. A new conceptual framework is now needed to take forward policy and practice for the twenty-first century if people’s rights and needs are to be met.

Key points

  • Attitudes to care are complex and contradictory. The priority, status and funding given to both paid and unpaid care and carers are limited and widely seen as inadequate.
  • Service users see the low value that is attached to care as resulting in a lack of adequate, appropriate, reliable and good quality services and support.
  • There have been increasing pressures towards the ‘commodification’ of care, and for it to be reduced to a set of standardised procedures and services.
  • The ‘apparent ordinariness’ of care is deceptive and can often hide sophisticated, highly skilled and much valued approaches to personal and social support which address difference and are committed to social justice.
  • Care can serve both to reinforce and to challenge inequalities and discrimination.
  • Two ideas have developed – the feminist ethic of care and disabled people’s philosophy of independent living, which offer competing policy approaches to care for the future.
  • Major changes are planned for social care policy and practice, based on the idea of ‘personalisation’. This aims to match support to the rights and needs of the individual rather than slotting them into existing services, and places an emphasis on ‘choice and control’ for the service user.
  • Mainstream public policy is as much creating as addressing support needs that require to be met.
  • While the demand for support is increasing, the supply of both formal and informal support is subject to increasing pressures.
  • The term ‘care’, a relatively recent arrival to public policy, has exceeded its sell-by date. It is undermined by its association with inequality and discrimination. A new language and conceptual framework is now required if people are to have the support more and more of us need to live our lives fully and on equal terms.
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